Age-Related Effect of Viral-Induced Wheezing in Severe Prematurity.

Geovanny Perez,Natalia Isaza,Krishna Pancham,Rosemary Megalaa,Shehlanoor Huseni,Carlos Rodriguez-Martinez,Bassem Kurdi,Gustavo Nino,Mary Rose,Dinesh Pillai,Amisha Jain

doi:10.3390/children3040019

Geovanny Perez, Natalia Isaza + Show 9 more

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https://doi.org/10.3390/children3040019

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Abstract

Premature children are prone to severe viral respiratory infections in early life, but the age at which susceptibility peaks and disappears for each pathogen is unclear. Methods: A retrospective analysis was performed of the age distribution and clinical features of acute viral respiratory infections in full-term and premature children, aged zero to seven years. Results: The study comprised of a total of 630 hospitalizations (n = 580 children). Sixty-seven percent of these hospitalizations occurred in children born full-term (>37 weeks), 12% in preterm (32–37 weeks) and 21% in severely premature children (<32 weeks). The most common viruses identified were rhinovirus (RV; 60%) and respiratory syncytial virus (RSV; 17%). Age-distribution analysis of each virus identified that severely premature children had a higher relative frequency of RV and RSV in their first three years, relative to preterm or full-term children. Additionally, the probability of RV- or RSV-induced wheezing was higher overall in severely premature children less than three years old. Conclusions: Our results indicate that the vulnerability to viral infections in children born severely premature is more specific for RV and RSV and persists during the first three years of age. Further studies are needed to elucidate the age-dependent molecular mechanisms that underlie why premature infants develop RV- and RSV-induced wheezing in early life.

Highlights

Early-life viral respiratory infection is a potentially modifiable risk factor for the development of lower airway obstruction in infants and children, and it represents a major cause of morbidity and mortality within this age group [1]
Epidemiology of Viral Respiratory Infections According to Gestational Age (GA)
To further examine the distinct age distribution observed in severely premature children, hospitalized due to viral respiratory infections, we modeled the age distribution according to viral hospitalized due to viral respiratory infections, we modeled the age distribution according to viral pathogens (RV, respiratory syncytial virus (RSV), human metapneumovirus (HMPV) and other viruses) in severely premature children

Summary

Introduction

Early-life viral respiratory infection is a potentially modifiable risk factor for the development of lower airway obstruction in infants and children, and it represents a major cause of morbidity and mortality within this age group [1]. Prior studies have shown viral respiratory infections in premature children are an increasing source of public health care utilization, due to multiple outpatient/emergency room visits and prolonged hospitalizations [2]. It is unclear until what age premature children remain highly vulnerable to respiratory viruses. Establishing the age range during which the predisposition to severe RV and RSV infections is still present in premature children can greatly benefit the design of preventive interventions and reduce the burden of severe viral respiratory illnesses in the 15 million babies born prematurely in the world each year [6,7]. RSV is the most frequent cause of lower respiratory tract infections (LRTIs) in young infants, and RV is the most commonly identified virus involved in wheezing exacerbations in older infants, preschool-aged and school-aged children [8]

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